Diabetes has a greater health impact on Americans than heart disease, substance use disorder or COPD, with 30.3 million Americans diagnosed with the illness and many more who are at risk for developing it.i According to the Blue Cross Blue Shield (BCBS) Health IndexSM, people with diabetes on average lose seven years of healthy life. Though these facts are concerning for those with the disease, everyone – diagnosed or not – should pay attention to how it might affect us all.

“The health and economic impact of diabetes for the United States cannot be overemphasized,” said Trent Haywood, M.D., J.D., senior vice president and chief medical officer for the Blue Cross Blue Shield Association (BCBS), which published a first of its-kind metric for measuring America’s Health.

The BCBS Health Index details the health impact of 200 diseases and found diabetes is one of the top 10 conditions impacting Americans. Here are five important takeaways from the data analysis — and what those numbers mean for us.

1 in 3 Americans are at high risk

In addition to the 30.3 million Americans who have been diagnosed with diabetes, there are another 84.1 million who have pre-diabetes, meaning their blood sugar levels are higher than normal, but not yet high enough to be considered Type 2 diabetes.ii Even more alarming, there are approximately 7.1 million Americans who have diabetes, but don’t know it.iii

These numbers speak to a significant health crisis, with implications extending beyond the disease itself and spreading into other economic, health and social factors of American life.

“Globally, the overall impact makes the United States workforce less competitive,” Haywood said. “Locally, it creates disproportional impact on communities that are hardest hit by the high prevalence rates.”

Diabetes is also linked to additional health and risk factors which Haywood says should be acknowledged.

“We must understand all of the complicating factors including an increase in stroke, heart attack and disabilities and the impact of those conditions on our families and communities.”

The health impact of diabetes grew fastest for young people; obesity is also high among this group. Experts suggest lifestyle and diet changes to help mitigate these trends.(Photo: mapodile, Getty Images)

Rates are rising among young people

Data from the BCBS Health Index shows that, between 2013 and 2015, the health impact of diabetes grew fastest for insured members between the ages of 18 and 34. According to the Centers for Disease Control and Prevention, rates for obesity within this age group also rose by more than 30% between 2001 and 2015, meaning more young people are in danger of developing diabetes now or in the future. The growing pool of young, at-risk Americans creates troubling implications for the future, when the potential spread of diabetes could mean significant costs for medical treatment and a decline in quality of life for millions.

Fortunately, for older age groups the health impact of diabetes has not grown significantly and in some cases even fell. For insured members between the ages of 55 and 64, the health impact of diabetes fell almost 2% during the same period that it rose for younger Americans.

Costs are on the rise, too

Diabetes costs over $12.1B annually to treat and impacts 6.8% of the commercially insured. One of the cost drivers is the rising cost of insulin, a hormone used to manage diabetes. BCBS data shows the cost of these drugs increased 137% from 2010-2017. The issue is further complicated by the fact that four commonly prescribed insulins — Lantus, Novolog, Levemir and Humalog — have proven difficult to replace with more affordable generic versions because of their complex formulas, part of an ongoing rise in Branded Patent Protected prescription drugs, as tracked by the Blue Cross Blue Shield Health of America Report.

“It is not sustainable,” Haywood said of the continued increase in prices. “The percentage of Americans with obesity, pre-diabetes and diabetes creates pressures on both the healthcare system and the economic system.”

Where you live might increase your risk

One of the key findings in the BCBS Health Index examination of diabetes is the disease’s comparatively high impact on communities in the Southeast and Central South regions of the United States, where the number of people with diabetes is about 50% higher than the national average. According to Haywood, this might be attributed to the availability of healthy foods.

“Often, Americans with diabetes are living in a “nutritional desert” with poor access to healthy food options which increases the overall negative health impact,” He said.

Though nutrition certainly plays a role, the overall picture is a bit more complicated due to factors beyond food intake. “The social and cultural components of diabetes combined with hereditary risk creates substantially disproportional impact for certain geographic regions.”

Haywood suggests approaching these “through community interventions and programs that are equally important to achieve better health outcomes.”

Prevention is the best medicine

Despite the factors that have exacerbated the spread of diabetes, experts agree that there is a simple answer to keep it from getting worse. The single most effective way to combat the epidemic of diabetes facing Americans is to keep people from getting it in the first place, and with the right education and awareness, rates should go down. After all, lowering your risk can be as simple as replacing one meal a day with a healthy alternative and increasing your exercise regimen.

“The diabetes epidemic is having an economic impact on individuals, families and on the health of the country,” Haywood said. “It is critical to take measures now.”

All trademarks and brands identified above are the property of their respective owners, which are in no way associated or affiliated with the Blue Cross and Blue Shield Association. Use of these trademarks and brands does not imply endorsement.